Review Paper: Effectiveness of Thoracic Manipulation on the Treatment of Patients With Mechanical Non-Specific Neck Pain

Introduction: Non-specific mechanical neck pain is a common musculoskeletal complaint that is generally treated conservatively using electro/thermal therapeutic agents, exercise, soft tissue techniques, and manual therapy. In this review, we evaluated the effectiveness of Thoracic Manipulation (TM) compared to cervical manipulations, multi-level TM with singlelevel TM, and TM with other interventions such as electro/thermal therapy and exercise. Material and Methods: PubMed, Google scholar and PEDro database were searched from inception until May 2016 by the following keywords: “neck pain”, “thoracic manipulation”, “physical therapy treatment”, “cervical manipulation”, and different combinations. Quality of the included studies were evaluated using physiotherapy evidence database [PEDro] scale. Results: A total of 15 studies out of 47 based on PEDro score were included in this review. All studies measured pain intensity as a parameter indicating effectiveness of interventions, 9 studies measured disability as a key outcome and used either NDI or NPQ for its assessment. Conclusion: Thoracic manipulation is equally effective as cervical manipulation in reduction of pain and improving function. Thoracic manipulation is also more effective than electrotherapy or exercise therapy alone. When combined with multimodal neck program, thoracic manipulation for patients with neck pain significantly improves function and reduces pain intensity.